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Vasectomy
Vasectomy is a surgical procedure in which the vasa deferentia of a man are cut for the purpose of sterilization. Decision process prior to vasectomy Vasectomy counselling Types There are some variations on the procedure such as no-scalpel (keyhole) vasectomies, in which a sharp hemostat, rather than a scalpel, is used to puncture the scrotum. Another type of vasectomy which may reduce the risk of chronic pain is called an "open ended" vasectomy. A "normal" vasectomy typically seals both ends of the vas deferens with stitches, heat, metal clamps or a combination, after cutting. The open-ended vasectomy obstructs only the top end of the vas deferens. With this method sperm leaks out from the lower severed end of the vas deferens and into the scrotum, thus hopefully avoiding a build-up of pressure in the epididymis. The likelihood of long-term testicular pain from "backup pressure" seems to be reduced using this method. Side effects After vasectomy, the testes remain in the scrotum where Leydig cells continue to produce testosterone and other male hormones that continue to be secreted into the blood stream. Some studies find that sexual desire is unaffected in over 90% of vasectomized men, whereas other studies find higher rates of diminished sexual desire. The sperm-filled fluid from the testes contributes about 10% to the volume of an ejaculation (in men who are not vasectomized) and does not significantly affect the appearance, taste, texture, or smell of the ejaculate.Post hernia surgery » Post Prostate Surgery When the vasectomy is complete, sperm can no longer exit the body through the penis. The testicles continue to produce sperm, but they are broken down and absorbed by the body. Much fluid content is absorbed by membranes in the epididymis, and much solid content is broken down by the responding macrophages and re-absorbed via the blood stream. Sperm is matured in the epididymis for about a month once it leaves the testicles. Approximately 50% of the sperm produced never make it to the orgasmic stage in a non-vasectomized man. After vasectomy, the membranes increase in size to absorb and store more fluid; this triggering of the immune system causes more macrophages to be recruited to break down and re-absorb more of the solid content. Within one year after a vasectomy, sixty to seventy percent of vasectomized men develop antisperm antibodies. In some cases, vasitis nodosa, a benign proliferation of the ductular epithelium, can also result. The buildup of sperm increases pressure in the vas deferens and epididymis. To prevent damage to the testes, these structures eventually rupture in more than half the cases. The entry of the sperm into the scrotum causes sperm granulomas to be formed by the body to contain and absorb the sperm which the body treats as a foreign substance. Effectiveness Early failure rates, i.e. pregnancy within a few months after vasectomy, are below 1%, but the effectiveness of the operation and rates of complications vary with the level of experience of the surgeon performing the operation and the surgical technique used. Although late failure, i.e. pregnancy after recanalization of the vasa deferentia, is very rare, it has been documented. Prevalence Worldwide, approximately 6% of married women using contraception rely on vasectomy. Compared to tubal ligations The rate of vasectomies compared to tubal ligations worldwide is extremely variable among countries, and the statistics are mostly based on questionnaire studies rather than actual counts of procedures performed. Worldwide, approximately five times as many married women rely on female sterilization as those relying on male sterilization. In the U.S. about 3 times as many women at risk for unintended pregnancy rely on tubal ligation as on vasectomy. In the U.S. tubal ligation is used more frequently than vasectomy, although the proportions vary from state to state. In Britain, vasectomy is more popular than tubal ligation, though this statistic may be as a result of the data-gathering method. Couples who opt for tubal ligation do so for a number of reasons, including: * Convenience of coupling the procedure with giving birth at a hospital. * Fear of side effects in the man. * Fear of surgery in the man. Couples who choose vasectomy are motivated by, among other factors: * The lower cost of vasectomy * The simplicity of the surgical procedure * The lower mortality of vasectomyhttp://findarticles.com/p/articles/mi_m0857/is_n1_v14/ai_18027036/pg_4 (for example 0.1 per 100,000 vasectomies vs. 4 per 100,000 tubal ligations in industrialized nations) * Fear of side effects in the woman * Fear of "major" surgery in the woman Complications Short-term complications include temporary bruising and bleeding, known as hematoma. The primary long-term complication is a permanent feeling of pain - Post-Vasectomy Pain Syndrome. Animal and human data indicate that vasectomy does not increase atherosclerosis and that increases in circulating immune complexes after vasectomy are transient. Furthermore, the weight of the evidence regarding prostate and testicular cancer suggests that men with vasectomy are not at increased risk of these cancers. Post-Vasectomy Pain Syndrome Post-Vasectomy Pain Syndrome (PVPS), genital pain of varying intensity that may last for a lifetime, is estimated to appear in between 5% and 35% of vasectomized men, depending on the severity of pain that qualifies for the particular studyAhmed I, Rasheed S, White C, Shaikh N. "The incidence of post-vasectomy chronic testicular pain and the role of nerve stripping (denervation) of the spermatic cord in its management." British Journal of Urology. 1997; 79:269-270. PMID 9052481Choe J, Kirkemo A. "Questionnaire-based outcomes study of nononcological post-vasectomy complications." The Journal of Urology. 1996; 155:1284-1286. PMID 8632554 McMahon A, Buckley J, Taylor A, Lloyd S, Deane R, Kirk D. "Chronic testicular pain following vasectomy." British Journal of Urology. 1992;69:188-191. PMID 1537032 Leslie TA, Illing RO, Cranston DW, Guillebaud J. "The incidence of chronic scrotal pain after vasectomy: a prospective audit." BJU International. 2007. PMID 17850378 The pain can be orchialgia, pain with intercourse, ejaculation, or physical exertion, or tender epididymides. In one study, vasectomy reversal was found to be 69% effective for reducing the symptoms of chronic post-vasectomy pain. Treatment options for 31% of patients whose pain did not respond to vasectomy reversal were limited. The study was very small, only evaluating 13 patients, making it difficult to draw solid conclusions. In severe cases castration has been resorted to. Granitsiotis P, Kirk D. "Chronic testicular pain: an overview." European Urology. 2005;47(5)720. PMID 15041105 Possible Vasectomy-Dementia Link Researchers reported in February 2007 that a survey of a small number of men with primary progressive aphasia, a rare speech disorder, found that more than twice as many as would be expected had undergone vasectomies. Because primary progressive aphasia is so rare compared to the number of men undergoing vasectomy it is statistically very unlikely that any one individual would develop this problem. The study has not yet been verified by other researchers, and the authors say larger studies are needed to better understand the issue. Psychological reactions Some men experience depression or anger and go through a period of mourning over the loss of their reproductive ability. This emotion is similar to what some women experience after menopause. Approximately half of all vasectomized men prefer to keep their sterilization secret. Depending upon the study, between five and eleven percent of men regret the decision to have a vasectomy. Reversal Although men considering vasectomies should not think of them as reversible, and most men and their spouses are satisfied with the operation, Turek P, "Minimally Invasive Reproductive Urology: The No-Scalpel Vasectomy." University of California-San Francisco. http://urology.ucsf.edu/patientGuides/pdf/maleInf/Vasectomy.pdf there is a procedure to reverse vasectomies using vasovasostomy (a form of microsurgery first performed by Earl Owen in 1971 ). Vasovasostomy is effective at achieving pregnancy in only 50%-70% of cases, and it is costly, with total out-of-pocket costs in the United States of approximately $7,000 Vasectomy Reversal Cost and Payment Plans http://www.vasectomyinfo.com/vasectomy_reversal_costs.html. The rate of pregnancy depends on such factors as the method used for the vasectomy and the length of time that has passed since the vasectomy was performed. The reversal procedures are frequently impermanent, with occlusion of the vas recurring two or more years after the operation. Since the body often produces antibodies against sperm, sperm counts are rarely at pre-vasectomy levels. There is evidence that men who have had a vasectomy may produce more abnormal sperm, which would explain why even a mechanically successful reversal does not always restore fertility. The higher rates of aneuploidy and diploidy in the sperms of men who have undergone vasectomy reversal may lead to a higher rate of birth defects . In order to allow a possibility of reproduction (via artificial insemination) after vasectomy, some men opt for cryostorage of sperm before sterilization. Availability * In the UK vasectomy is often available free of charge through the National Health Service upon referral by one's GP. However, some PCTs do not fund the procedure. There are private clinics (such as Marie Stopes International) who perform the operation with short waiting times. * The vasectomy is also covered in Canada. * In 2006 Argentina approved Vasectomy in Public Health Service See also *Male contraceptive References Further reading Key texts Books *Kincaid, D. L., Merritt, A. P., Nickerson, L., Buffington, S. d. C., de Castro, M. P. P., & de Castro, B. M. (2002). Impact of a mass media vasectomy promotion campaign in Brazil. Mahwah, NJ: Lawrence Erlbaum Associates Publishers. *Mumford, S. D. (1977). Vasectomy counseling. Oxford, England: San Francisco Press. *Mumford, S. D. (1977). Vasectomy: The decision-making process. Oxford, England: San Francisco Press. Papers Aitken, R. J., & Carter, J. (1977). Behavioural consequences of vasectomy in the mouse: Experientia Vol 33(10) 1977, 1396-1397. *Amor, C., Rogstad, K. E., Tindall, C., Moore, K. T. H., Giles, D., & Harvey, P. (2008). Men's experiences of vasectomy: A grounded theory study: Sexual and Relationship Therapy Vol 23(3) Aug 2008, 235-245. *Arevalo, J. A., Wollitzer, A. O., & Arana, S. (1987). Vasectomy: Views of Latinos and White men: The Journal of Family Practice Vol 24(5) May 1987, 493-496. *Aron, B., Morales, P. A., & Amelar, R. (1973). Community response to free vasectomy: New York State Journal of Medicine Vol 73(18) Sep 1973, 2270-2275. *Balde, A., Legare, F., & Labrecque, M. (2006). Assessment of needs of men for decision support on male sterilization: Patient Education and Counseling Vol 63(3) Nov 2006, 301-307. *Bloom, L. J., & Houston, B. K. (1976). The psychological effects of vasectomy for American men: Journal of Genetic Psychology Vol 128(2) Jun 1976, 173-182. *Boateng, W. (2000). Community perception of male sterilization: The case of greater Accra region of Ghana: IFE Psychologia: An International Journal Vol 8(1) 2000, 195-211. *Bourgeois, M. (1982). Vasectomy and tubal ligation: Medicopsychological aspects of voluntary sterilization: Psychologie Medicale Vol 14(8) Jun 1982, 1195-1201. *Bourgeois, M., & Audebert, A. (1974). Vasectomy: Psychiatric aspects of voluntary masculine sterilization: Annales Medico-Psychologiques Vol 2(1) Jun 1974, 61-87. *Brownlee, H. J., & Tibbels, C. K. (1983). Vasectomy: The Journal of Family Practice Vol 16(2) Feb 1983, 379-384. *Buchholz, N.-P., Weuste, R., Mattarelli, G., Woessmer, B., & et al. (1994). Post-vasectomy erectile dysfunction: Journal of Psychosomatic Research Vol 38(7) Oct 1994, 759-762. *Burnell, G. M., & Norfleet, M. A. (1986). Psychosocial factors influencing American men and women in their decision for sterilization: Journal of Psychology: Interdisciplinary and Applied Vol 120(2) Mar 1986, 113-119. * *Canfield, M. R. (1972). The effect of vasectomy upon personality characteristics and sexual adjustment: Dissertation Abstracts International Vol. *Carment, D. W., & Paliwal, T. R. (1973). Correlates of birth control practices in India: Journal of Cross-Cultural Psychology Vol 4(1) Mar 1973, 111-119. *Clarke, L., & Gregson, S. (1986). Who has a vasectomy reversal? : Journal of Biosocial Science Vol 18(3) Jul 1986, 253-259. *Cole, S. G., & Bryon, D. (1973). A review of information relevant to vasectomy counselors: The Family Coordinator Vol 22(2) Apr 1973, 215-221. *David, H. P. (1978). Review of Vasectomy counseling: PsycCRITIQUES Vol 23 (2), Feb, 1978. *David, H. P. (1978). Vasectomy--The decision-making process: A guide for promoters: PsycCRITIQUES Vol 23 (2), Feb, 1978. *Deb, S. (2003). A Kap study on family planning methods with special reference to condom and vasectomy: Social Science International Vol 19(1) Jan 2003, 93-101. *Dias, P. L. (1983). The long-term effects of vasectomy on sexual behaviour: Acta Psychiatrica Scandinavica Vol 67(5) May 1983, 333-338. *Dilbaz, B., Cil, A. P., Gultekin, I. B., Caliskan, E., Kahyaoglu, Z., & Dilbaz, S. (2007). Outcome of vasectomies performed at a Turkish metropolitan maternity hospital: The European Journal of Contraception and Reproductive Health Care Vol 12(1) 2007, 19-23. *Ewalds-Kvist, S. B. M., Rantala, M., Nikkanen, V., Selander, R. K., & Lertola, K. (2003). The response of the Finnish man to vasectomy: Psychology, Health & Medicine Vol 8(3) Aug 2003, 335-369. *Freund, M., & Davis, J. E. (1973). A follow-up study of the effects of vasectomy on sexual behavior: Journal of Sex Research Vol 9(3) Aug 1973, 241-268. *Gandy, R. J. (1978). Characteristics of vasectomy patients at a family planning clinic: Journal of Biosocial Science Vol 10(2) Apr 1978, 125-132. *Goebel, P. (1988). On the development of the desire to become fertile once more in men who have undergone vasectomies: Praxis der Psychotherapie und Psychosomatik Vol 33(6) Nov 1988, 310-320. *Goebel, P., Ortmann, K., & Blattner, T. (1987). Vasectomy and relationship patterns: An empirical investigation of 156 men (couples): Zeitschrift fur Psychosomatische Medizin und Psychoanalyse Vol 33(2) 1987, 119-138. *Goldsmith, A., & Goldberg, R. J. (1974). Psychosocial aspects of vasectomy in Latin America: Journal of Sex Research Vol 10(4) Nov 1974, 278-292. *Grindstaff, C. F., & Ebanks, G. E. (1973). Vasectomy: Canada's newest family planning method: Canada's Mental Health Vol 21(5) Sep 1973, 3-5. *Gutmann, M. C. (2005). Scoring Men: Vasectomies and the Totemic Illusion of Male Sexuality in Oaxaca: Culture, Medicine and Psychiatry Vol 29(1) Mar 2005, 79-101. *Hafemann, S. F., & Chilman, C. S. (1974). Implications of vasectomy for social work practice: Social Casework Vol 55(6) Jun 1974, 343-351. *Hamersma, R. J., Miller, C., Anderegg, T., & Rudolph, B. (1975). Psychological dynamics and self-perceptions of vasectomy candidates: Perceptual and Motor Skills Vol 40(3) Jun 1975, 1004-1006. *Hill, G. M., Vermillion, M. E., & Gershbein, L. L. (1979). Behavioral studies of vasectomized rats and mice: Research Communications in Psychology, Psychiatry & Behavior Vol 4(4) 1979, 433-445. *Hofmeyr, D. G., & Greeff, A. P. (2002). The influence of a vasectomy on the marital relationship and sexual satisfaction of the married man: Journal of Sex & Marital Therapy Vol 28(4) Jul-Sep 2002, 339-352. *Horenstein, D., & Houston, B. K. (1975). The effects of vasectomy on postoperative psychological adjustment and self-concept: Journal of Psychology: Interdisciplinary and Applied Vol 89(2) Mar 1975, 167-173. *Humphrey, M., & Humphrey, H. (1993). Vasectomy as a reason for donor insemination: Social Science & Medicine Vol 37(2) Jul 1993, 263-266. *Hunter, K. I., Linn, M. W., & Harris, R. (1981). Relationship between women's attitudes and choice of birth control: Psychological Reports Vol 49(2) Oct 1981, 372-374. *James, W. H. (1994). Prostatic cancer, coital rates, vasectomy and testosterone: Journal of Biosocial Science Vol 26(2) Apr 1994, 269-272. *Janke, L. D., & Wiest, W. M. (1976). Psychosocial and medical effects of vasectomy in a sample of health plan subscribers: International Journal of Psychiatry in Medicine Vol 7(1) 1976-1977, 17-34. *Kenyon, P. R., Morel, P. C. H., Morris, S. T., & West, D. M. (2008). A note on the effect of vasectomised rams and short-term exposures to entire rams prior to the breeding period on the reproductive performance of ewe lambs: Applied Animal Behaviour Science Vol 110(3-4) Apr 2008, 397-403. *Khandaker, R. I., Vereecken, R. L., & Nijs, P. (2001). Anticonceptive problems in Bangladesh: An approach by case reports: Sexual and Relationship Therapy Vol 16(4) Nov 2001, 365-371. *Kohli, K. L., & Sobrero, A. J. (1973). Vasectomy: A study of psychosexual and general reactions: Social Biology Vol 20(3) Sep 1973, 298-302. *Manhoso, F. R., & Hoga, L. A. K. (2005). Men's experiences of vasectomy in the Brazilian Public Health Service: International Nursing Review Vol 52(2) Jun 2005, 101-108. *Marchi, N. M., de Alvarenga, A. T., Osis, M. J. D., & Bahamondes, L. (2008). Contraceptive methods with male participation: A perspective of Brazilian couples: International Nursing Review Vol 55(1) Mar 2008, 103-109. *Maschhoff, T. A., Fanshier, W. E., & Hansen, D. J. (1976). Vasectomy: Its effect upon marital stability: Journal of Sex Research Vol 12(4) Nov 1976, 295-314. *Merwin, G. H. (1974). Vasectomies: Who's having them . . . and why? : Health Education Monographs Vol 2(3) Fal 1974, 260-277. *Miller, W. B., & Shain, R. N. (1985). Married women and contraceptive sterilization: Factors that contribute to pre-surgical ambivalence: Journal of Biosocial Science Vol 17(4) Oct 1985, 471-479. *Miller, W. B., Shain, R. N., & Pasta, D. J. (1985). A model of the determinants in married women of sterilization method choice: Population & Environment: Behavioral & Social Issues Vol 8(3-4) Fal-Win 1985-1986, 223-239. *Miller, W. B., Shain, R. N., & Pasta, D. J. (1990). The nature and dynamics of post-sterilization regret in married women: Journal of Applied Social Psychology Vol 20(6, Pt 1) Apr 1990, 506-530. *Miller, W. B., Shain, R. N., & Pasta, D. J. (1991). The pre- and poststerilization predictors of poststerilization regret in husbands and wives: Journal of Nervous and Mental Disease Vol 179(10) Oct 1991, 602-608. *Miller, W. B., Shain, R. N., & Pasta, D. J. (1991). The predictors of post-sterilization regret in married women: Journal of Applied Social Psychology Vol 21(13) Jul 1991, 1083-1110. *Mistry, T. C. (1987). Impact of power and incentive in the process of decision-making for sterilization: Indian Psychological Review Vol 32(1) Jan 1987, 1-13. *Mullen, P., Reynolds, R., Cignetti, P., & Dornan, D. (1973). A vasectomy education program: Implications from survey data: The Family Coordinator Vol 22(3) Jul 1973, 331-338. *No authorship, i. (1986). Negligence claims: Mental & Physical Disability Law Reporter Vol 10(3) May-Jun 1986, 201-202. *Parsons, M. A., & Wood, H. A. (1978). Demographic and socio-economic characteristics of men choosing vasectomy: Journal of Biosocial Science Vol 10(2) Apr 1978, 133-139. *Penteado, L. G., Cabral, F., Diaz, M., Diaz, J., Ghiron, L., & Simmons, R. (2001). Organizing a public-sector vasectomy program in Brazil: Studies in Family Planning Vol 32(4) Dec 2001, 315-328. *Phoenix, C. H. (1973). Sexual behavior in rhesus monkeys after vasectomy: Science Vol 179(4072) Feb 1973, 493-494. *Phoenix, C. H., & Alexander, N. J. (1979). Sexual behavior in long-term vasectomized male rhesus monkeys: Physiology & Behavior Vol 22(4) Apr 1979, 747-751. *Presser, H. B., & Bumpass, L. L. (1972). The acceptability of contraceptive sterilization among U.S. couples: 1970: Family Planning Perspectives Vol 4(4) Oct 1972, 18-26. *Rob, U., & Cernada, G. P. (2003). Manager's Attitudes Toward Involvement of Males in Pakistan's Family Planning Program: International Quarterly of Community Health Education Vol 22(4) 2003-2004, 279-286. *Roberto, E. L. (1974). Marital and family planning expectancies of men regarding vasectomy: Journal of Marriage & the Family Vol 36(4) Nov 1974, 698-706. *Rogstad, K. E. (1996). The psychological effects of vasectomy: Sexual & Marital Therapy Vol 11(3) Aug 1996, 265-272. *Santiso, R., Pineda, M. A., Marroquin, M., & Bertrand, J. T. (1981). Vasectomy in Guatemala: A follow-up study of five-hundred acceptors: Social Biology Vol 28(3-4) Fal-Win 1981, 253-264. *Shain, R. N., Miller, W. P., & Holden, A. E. (1984). The decision to terminate childbearing: Differences in preoperative ambivalence between tubal ligation women and vasectomy wives: Social Biology Vol 31(1-2) Spr-Sum 1984, 40-58. *Sharma, B. P. (1971). Observation of patients following vasectomy in Nepal: International Journal of Social Psychiatry Vol 17(4) Win 1971, 287-291. *Singh, D., & Shukla, S. R. (1973). A critical study of family planning work in Kalyanpur: Society & Culture Vol 4(1) Jan 1973, 31-36. *Uehling, D. T. (1974). When a patient requests vasectomy: Medical Aspects of Human Sexuality Vol 8(9) Sep 1974, 191-192. *Uhlman, G. E. (1974). Incidence of vasectomies refused and reasons for refusal: Public Health Reports Vol 89(5) Sep-Oct 1974, 447-450. *Uhlman, J., & Weiss, G. (1986). Screening the vasectomy applicant: Reassessing the importance of eligibility criteria: Social Biology Vol 33(1-2) Spr-Sum 1986, 102-108. *Uhlman, J., & Weiss, G. (1988). Performed and refused vasectomy: A decade of waning popularity and increasing awareness of safety: Social Biology Vol 35(1-2) Spr-Sum 1988, 41-49. *Vaughn, R. L. (1979). Behavioral response to vasectomy: Archives of General Psychiatry Vol 36(7) Jul 1979, 815-821. *Weintraub, S., Fahey, C., Johnson, N., Mesulam, M.-M., Gitelman, D. R., Weitner, B. B., et al. (2006). Vasectomy in Men with Primary Progressive Aphasia: Cognitive and Behavioral Neurology Vol 19(4) Dec 2006, 190-193. *Wiest, W. M., & Janke, L. D. (1974). A methodological critique of research on psychological effects of vasectomy: Psychosomatic Medicine Vol 36(5) Sep-Oct 1974, 438-449. *Wilkinson, D. J., Lyman, P. F., Mason, K., & Wambwa, G. E. (1993). Using the newspaper to disseminate vasectomy information in Kenya: International Quarterly of Community Health Education Vol 14(2) 1993-1994, 165-172. *Wilkinson, D. J., Lyman, P. F., Mason, K., & Wambwa, G. E. (1993). "Using the newspaper to disseminate vasectomy information in Kenya": Errata: International Quarterly of Community Health Education Vol 14(3) 1993-1994, 319. *Wincze, J. P. (1989). Helpful Information About Male Sexuality: PsycCRITIQUES Vol 34 (11), Nov, 1989. *Wolfers, D., & Wolfers, H. (1973). Vasectomania: Family Planning Perspectives Vol 5(4) Fal 1973, 196-199. *Wolfers, H., Subbiah, N., & bin Mazurka, A. (1973). Psychological aspects of vasectomy in Malaysia: Social Biology Vol 20(3) Sep 1973, 315-322. *Wright, M. R. (1972). Psychological aspects of vasectomy counseling: The Family Coordinator Vol 21(3) Jul 1972, 259-265. *Wright-Williams, S. L., Courade, J.-P., Richardson, C. A., Roughan, J. V., & Flecknell, P. A. (2007). Effects of vasectomy surgery and meloxicam treatment on faecal corticosterone levels and behaviour in two strains of laboratory mouse: Pain Vol 130(1-2) Jul 2007, 108-118. *Wyndham, D. (2003). Versemaking and lovemaking--W. B. Yeats' "strange second puberty": Norman Haire and the Steinach rejuvenation operation: Journal of the History of the Behavioral Sciences Vol 39(1) Win 2003, 25-50. Additional material Books Papers *Google Scholar Dissertations *Bush, R. W. (1975). Selected psychological effects of vasectomy: Dissertation Abstracts International. *Cord, E. L. (1972). A study of certain personality factors incident to vasectomy as an adjustmental device: Dissertation Abstracts International Vol. *Cottrell, J. S. (1986). Sterilization effects on couples measured by MMPI, CPI, PVA and Leary ITP: Dissertation Abstracts International. *Kendall, P. J. (1972). The relationship of vasectomy to self concept: Dissertation Abstracts International Vol. *Magarick, R. H. (1976). Social and emotional aspects of voluntary childlessness in vasectomized childless men: Dissertation Abstracts International. *McCoy, D. B. (1988). Identity transition in persons undergoing elective interval sterilisation and vasectomy: An approach based on identity structure analysis: Dissertation Abstracts International. *Mumford, S. D. (1977). The decision-making process that leads to vasectomy: Dissertation Abstracts International. *Vaughn, R. L. (1977). Alteration of attitudes of college males toward the use of vasectomy as a contraceptive procedure: Dissertation Abstracts International. External links *http://www.vasectomy-faq.com/What-Happens-to-Sperm-after-a-Vasectomy.php *The No-Scalpel Vasectomy. *Family Planning: A Global Handbook for Providers Chapter 12:Vasectomy *Articles on Vasectomies and Vasectomy Reversals *Information for Making a Vasectomy Decision *Vasectomy information from a non institutional source *No-Scalpel Vasectomy: The NSV Book *Video: The NSV Procedure (graphic) Category:Birth control Category:Contraception for males Category:Surgical contraception Category:Sterilization Category:Surgery